“We treat regardless of citizen status,” Chun said. “We don’t ask. We just treat.”

Other challenges remain for immigrants’ access to health care. Medicaid also does not cover long-term care for illegal immigrants or even newly legalized immigrants.

Hospitals have been known to coordinate cross-border flights that allow an immigrant to receive long-term treatment in their home country. Larsen said she has talked with some inner-city organizations in Chicago that have arranged those transfers, but she was not aware that Centegra ever had to do it.

Immigration status or not, a patient’s health should be the top priority for any community hospital, Larsen said.

“For us, we are incredibly committed to serving our community, regardless of status,” she said. “What is important is that they walk out of our doors better than when they walked in.”

The cost of unreimbursed care

Unreimbursed care includes charity care and bad debt, and adds up to billions for hospitals nationwide.

Nationally

• 4,973 hospitals in 2011 provided $41.1 billion in unreimbursed care

• 4,985 hospitals in 2010 provided $39.3 billion in unreimbursed care

• 5,008 hospitals in 2009 provided $39.1 billion in unreimbursed care

In Illinois, hospitals spent $1.5 billion in unreimbursed care in 2012

• Centegra Health System spent $40.2 million in 2012

Sources: American Hospital Association, Illinois Hospital Association, Centegra Health System